The primary aim of the project is to conduct a randomized trial to evaluate the impact of a primary care based intervention consisting of physician-delivered self-help materials, written personalized feedback and supportive telephone counseling in a population-based sample of at- risk drinkers. At-risk drinking is defined as: reported consumption of an average of two or more standard drink equivalents per day in the prior month, or consumption of five drinks or more on at least two occasions in the prior month, or driving after consuming more than two alcoholic drinks on one or more occasions in the prior month. Additional goals are to: (a) Describe the population of at-risk drinkers with regard to their readiness to change and compare drinking patterns, drinking-related consequences, family history, and motivations of drinkers across the stages of changes; (b) Conduct process analyses to assess the impact of the self-help interventions on conceptually-derived variables which are hypothesized to mediate changes in drinking practices; and (c) Assess pre-post changes in physicians' knowledge, practices and confidence regarding screening and intervention for at-risk drinking and post- intervention satisfaction with the self-help intervention. Seven physician practices will participate in this study. A telephone survey of approximately 2900 patients who have appointments with their primary care physician will be conducted to identify approximately 300 at-risk drinkers for the randomized trial. At-risk drinkers will be randomized to usual care (n=150) or intervention (n=150) groups. Telephone survey follow-ups will occur 3 & 12 months after randomization to obtain data on stage of change, motivation, current drinking practices, psychosocial factors, and the use of the intervention materials. Collateral reports of drinking behavior will be obtained at both follow-ups. Morbidity and health care utilization of all intervention groups will be followed using Group Health Cooperative medical records and computerized data systems. The long-term goal is to provide a protocol for identifying and treating at-risk drinkers in a primary care delivery system.